All Aboard Zoo Train (An App Review)


Zoo Train
by Busy Bee Studios® is a delightful and interactive app for toddler s and preschoolers.  This app has 5 different games and activities targeting a variety of skills.

  1. Music – Train whistles provide a variety of tunes.  Children can select programmed songs such as Twinkle, Twinkle Little Star or they can touch the train whistles and create their own songs.
  2. Puzzles – Children can complete the targeted puzzles and then name the picture.  After each puzzle is completed, a train on the bottom of the screen moves closer to the station.
  3. Letter Matching – A train pulls a targeted word across the screen.  Children match letters to spell the targeted word, a picture of the word appears as well.
  4. Build a Train – Children place the tracks on the screen to build a train track.  This works on problem solving and spatial awareness skills.  After completing the train tracks, a colorful train appears and travels around the track.
  5. Zoo Train – This activity allows children to build their own train.  From the lion driving the engine to the different train cars with animals and the caboose, children are able to make choices to create their own unique train.  Then, they choose where the train is heading – to the beach, the city, the farm or the neighborhood!  The different choices and combinations allow children to be creative and works on increasing their expressive language skills.

This app is highly rated amongst parents, teachers and therapists and it’s easy to see why.  For only $0.99, this app provides a variety of learning opportunities for children to enjoy!

Do Sensory Processing Disorders Exist?


At the end of May 2012, the American Academy of Pediatrics issued a policy statement recommending doctors look for the presence of another developmental condition such as autism, developmental coordination disorder, attention-deficit hyperactivity disorder, etc. when a child shows signs of sensory issues.   They went on to say that this is recommended because, “there is no universally accepted framework for diagnosis, sensory processing disorder generally should not be diagnosed” and “. . . at this time, pediatricians should not use sensory processing disorder as a diagnosis.”  This statement leaves everyone asking, “do sensory processing disorders exist?”  If so, how and when do we provide treatment?

Sensory Processing Disorder (SPD) is a difficulty or difference in the brain’s ability to receive and process sensory stimulation from the body and the environment.  It is a neurological disorder where the connections in the brain appear to be too strong, too weak, or mis-wired, resulting in difficulty participating in normal daily activities.  It is estimated that around 20% of the population has some type of SPD, but it often goes undiagnosed.  SPD is often seen in conjunction with other diagnoses such as Autism Spectrum Disorders (ASD), Cerebral Palsy, ADD/ADHD, and many other childhood disabilities.

Children with Sensory Processing Disorder take in and process sensory information differently than the general population.  Normal sensory events and information are often reacted to in and under or over-responsive manner.  The senses impacted by SPD include our 5 senses of sight, sound, taste, smell, and touch.  It also includes 2 lesser-knows senses including the proprioceptive and vestibular systems.  The vestibular system is related to the inner ear, and processes our body’s position in space and sense of movement.  How we react to swinging, roller-coasters, or being upside down is determined by the vestibular system.  Proprioception is the body’s sense of placement in relation to itself and the environment and is sent to the brain through receptors in joints and muscles.  Proprioception is the ability to close your eyes and know what position your arms and legs are in.  Children with proprioceptive problems often have uncoordinated motor skills and frequently trip and run into objects.  Many children with SPD often crave this proprioceptive input and are constantly prefer wrestling, jumping and squishing activities that makes them feel secure by being aware of their bodies.

Occupational Therapy (OT) is the therapy domain that primarily treats SPD.  A sensory processing evaluation is done with a child and it is determined which senses are impacted and how it affects the child’s daily functioning.  Each system is examined and it is determined which senses are hyper-responsive or under-responsive.  Most children have a mixture of both, depending on the sensation.  Children with SPD usually have trouble with eating (picky eaters), dressing (tolerating the feel of certain clothing), play (avoiding messy textures, fear of movement, or playing too rough) and transitioning between activities and to different environments.

Treatment for SPD includes working with the child’s parents to create a Sensory Diet, which is a program designed for that child to provide his/her body with the sensations they need or crave to function optimally while also slowly and systematically exposing them to the sensations they do not tolerate well to desensitize their nervous system.  Through OT, we can actually re-wire those brain connections so children can function more effectively in their daily lives.

The important thing to realize is that SPD is a real disorder and effective treatment is available.

Yes, we do need further research to learn more about the long term effectiveness of specific sensory processing treatments. Yes, most children do exhibit sensory processing issues in addition to other primary diagnoses.  Yes, the treatment for sensory processing is different for each child.  However, we must remember that there have been numerous studies conducted showing that some children are diagnosed with SPD without other diagnoses present. As with all therapeutic treatments, we must also remember that each child is an individual and has their own individual needs and processes information differently based on their individual needs.

If a child is exhibiting signs of SPD, the treatment for sensory processing issues must be included in the child’s treatment protocol and must be developed by a trained and certified sensory integration professional.  If left untreated, these children with sensory processing issues may be misdiagnosed with other “behavior issues” and their underlying sensory processing issues will be left undiagnosed and untreated.  This could lead to more frustration for both the child and parents and a great emotional cost to the entire family.

The next edition of the DSM V (Diagnostic and Statistical Manual of Mental Disorders) will be released in 2013.  Several advocacy groups have lobbied for sensory processing disorders to formally be included in the new edition.  The final decision will be released later this year (2012).  If approved, sensory processing disorders will finally be recognized as a true disorder and children and adults with SPD will be able to get the services they need.  To stay updated on the final ruling, please visit the SPD Foundation.

For more information about Sensory Processing Issues, the following books and websites are recommended:

The Out of Sync Child by Carol Kranowitz
Sensational Kids by Lucy Jane Miller

Sensory Processing Disorder
SPD Foundation
Sensational Brain

Maintaining a Conversation

One of the most important social and communication skill children need to learn is that of maintaining a conversation.  For some children, this can be challenging.  Children with developmental and social delays may not have the skills necessary to maintain and carry-on conversations with others.  Here are a few tips to encourage conversations:

Ask Closed Questions:   Asking and answering “yes/no” and “wh” questions are important skills for children to learn and may be a good way to start a conversation.  These questions may include:  “Did you go to school today?   What color is your shirt? What did you eat for lunch?, etc.”  However, once the child answers these questions, move on to open ended questions as soon as possible to avoid “grilling” and “drilling” the child with questions. 

Ask Open Ended Questions:  These questions have many different answers and allow for more cognitive and language skills.  Questions such as, “What should we have for lunch?, What would you like to play? etc”  are great for maintaining conversations because they allow for a more back-and-forth exchange.

Observations and Statements:  Making statements such as “I wonder what will happen”  and observations such as “tell me about this picture” provide cues to encourage the child to produce words and phrases.  Statements and observations also show the child that you’re interested in the same things they are and tend to be more child centered.

Provide Opportunities:  Throughout the day, set-up opportunities for you and your child to have a meaningful conversational exchange.  Driving in the car, looking at books and sitting at the dinner table are great times to encourage conversations.

Practice: Set up situations for your child to practice these above mentioned skills.  This could be during play dates with peers, at community events (e.g. church, boy scouts, girl scouts, etc), playing board games, etc.  Also, using electronic devices (e.g. iPad, tablets, etc) provide specific apps for practicing social situations and encourage language skills.  These devices provide opportunities to pause and talk about a specific situation and to repeat activities as many times as necessary.    A few apps to encourage conversations and spontaneous language include:

Buildo Rescue Sticker Book – This is an interactive sticker book app with four scenes (fire fighters, police, hospital and water rescue).  Children are able to manipulate the stickers and create their own scenarios.  Each sticker makes a specific sound.  While the “people” stickers do produce sounds, they do not produce any true words in English – this allows the app to be language neutral.  However, the purpose of this app is not to imitate the speech sounds, but to create picture boards to encourage conversations and spontaneous language.

Lenord Furry Friend – This interactive app imitates what the child says.  Children can tickle his belly or ear, blow the pinwheel, pop his balloon and bubbles, watch him drink and eat and wake him up when he’s sleeping.

My Play Home This interactive app is great for language development.  Children can move the people around the house and talk about what the people are doing.  It’s great for answering questions, making observations and statements, following directions and working on pronouns and action verbs.

Conversation Builder – This app is designed for elementary school aged children.  It allows children to practice conversations in a variety of social settings.  Children are able to record their conversation and play it back for auditory feedback.  They learn when it’s appropriate to introduce themselves, ask questions, make observations and change the subject of the conversation.

Board Games: A Fun Way to Target Developmental Skills


Board games have been around for a long time.  In fact, they can be traced back to as early as 2500 BC.  Games have been played throughout history as a way to enjoy each other’s company and as a way to rest and relax.  With all the technological advancements, many kids these days play games using hand-held electronic devices.  While playing with these electronic devices may work on hand-eye coordination, there are many skills children learn only by opening a box, sitting around the table and playing a traditional board game with family and friends.

Taking Turns:  One of the most obvious developmental skills targeted while playing board games is turn-taking.  Children learn when it’s their turn to play and when they have to wait for someone else.  Just about every game with 2 or more players incorporates this skill, while also working on sharing and interpersonal skills with others.

Following Directions:  Each game has its own set of rules and directions to follow.  While playing these games, children are learning how, when, where and why you do certain things – which aid in critical thinking and problem solving.  Every game you play targets this skill.

Increasing Vocabulary: Children learn a lot about language by hearing it.  Games provide opportunities for language growth and development.  Children learn a variety of words specific to each game and are introduced to new words and their meanings.

Being a Good Sport:
  While playing board games, there is typically one person or one team that wins.  Children learn how to be a good winner without gloating or bragging and how to lose with dignity without whining or crying.  They also learn how to be patient and let others complete their moves without telling them what to do.

Encouraging Math Skills:  Many games require counting skills.  You count the spaces you move, count the pieces you have left or the pieces you may need.  Other math skills targeted include adding points at the end of the game, sorting and matching pictures and game pieces, sequencing skills, etc.

Asking Questions:  Introducing new games allows children to work on skills like asking “yes/no” and “wh” questions. Clarifying how, who, what, when, etc. is great practice for children. Other games, like Guess Who?, incorporate asking questions into the game itself.

Increasing Social Interactions:  There are very few board games you can play by yourself.  Most games require 2 – 4 players.  Board games encourage pragmatics (social interactions) and may decrease anxiety some children face while talking with others. Once the game begins and the players start talking about the game, there are a variety of social cues children will learn.  These social cues include maintaining eye contact with others, understanding facial expressions, nonverbal gestures, etc.  It’s important for children to learn and understand these social cues and these are skills that will carry-over while interacting with others in society.

Increasing Cognitive Skills:  There are numerous games where children must identify, name and match pictures, colors and shapes.  Other cognitive skills include problem solving and making choices. When someone plays a move that blocks you or grants you an opportunity, you have to use your problem solving skills to figure out what to do next.  Making choices and planning what to do next are skills which will carry-over throughout the child’s life.

Maintaining Attention to Tasks:  The length of a board game can range from a few minutes to several hours. Be sure to choose games that are appropriate for your child and will help them focus and complete an activity. We want board games to be a positive experience for them.  Finishing what you start is another life skill targeted while playing board games.

Bonding With Others:  This is perhaps the most important skill children may learn.  Games allow people to bond.  Whether it’s a family game night or hanging out with friends, time together allows children to feel secure, feel like they are part of the “group” and interact with others while doing something fun.

Board games are a great learning tool for your family and/or classroom.  Remember to keep it fun and choose games that are appropriate for your child.  If you need help choosing the right games, check out the list below for more information.  So, grab a game and your family and start playing!  Have fun!

Preschool Games (ages 3 – 5 years)
Chutes and Ladders
Candy Land
Connect 4
Guess Who?
Sorry  
Checkers
Feed the Kitty 
Hisss
Step To It 
Memory

Early Elementary (ages 5 – 8 years)
Chess
Scrabble Jr.
Boggle Jr.
Zingo
Monopoly Jr.   
Junior Labyrinth
Carcassone 
Ticket to Ride
Game of Life
Pay Day
What’s G’Nu?
Password Junior
Rat-A-Tat Cat Deluxe  
Mancala

Older Kids – Adults (ages 8 and up)
Clue
Scrabble
Thurn and Taxis
Boggle
Parcheesi
Settlers of Catan   
Ticket to Ride (all the expansions + countries)
Smart Mouth  
Pictureka!
Carcassone: Hunters and Gatherers 
Sequence
Elfenland
Stone Age
RoboRally
Dominon

Encouraging Feeding Skills

Eating is a complex process.  Children may have difficulty eating a well balanced meal due to difficulties coordinating their oral motor skills and/or difficulties with sensory processing issues.

Oral-motor skills include moving the tongue and lips in coordinated movements to bite and chew food.  If your child coughs, chokes or gags while eating or drinking, please consult with your child’s speech-language pathologist and pediatrician.  These signs may indicate the need for a “swallow study” to fully evaluate your child’s swallowing safety.

Others may have sensory issues surrounding feeding. They may be sensitive to food textures and reject all foods that are mushy or crunchy.  Some are sensitive to temperatures or even strong smells. Many toddlers may reject foods on sight, or are resistant to trying anything unfamiliar.

The reasons behind eating difficulties can be as varied as the children themselves, but the treatment is the same – positive, guided interactions with a variety of food in a safe, supportive environment. Children also need to be taught and encouraged to appropriately refuse foods they are not ready to try.  Force feeding should never be an option.

Dr. Kay Toomey, a psychologist and creator of the SOS (Sequential Oral Sensory) Approach to Feeding, has developed the following strategies for parents to use at home (Toomey, 2004):

Structure:  We provide safety and routine to children by offering meals at the same time, in the same place, with the same people.  These routines and scheduled meals and snacks provide awareness of the sensations of fullness and hunger.

Social Modeling:  Children learn by watching others.  Having regular family meals where everyone eats the same foods offers children a chance to interact with family members and a variety of foods in a supportive environment.

Positive Reinforcement:   Children who have issues with eating have often had unpleasant or even frightening experiences while eating.  We want to create a positive, supportive environment for all children.  Praise any and all interactions with foods by clapping, cheering and/or offering verbal praise.  Positive reinforcement avoids the negative effects caused by punishment (such as the loss of appetite) and decreases attention seeking through negative behaviors.

Make Foods Manageable:   Provide food in small pieces or thin strips that can be easily held and chewed by toddlers.  Toddlers can be visually overwhelmed fairly easily.  Provide foods that the child likes and eats all the time, along with at least 1 challenging food at each meal and snack.  Present the food repeatedly – it takes 10 to 15 different interactions, on separate occasions, with the same food, for that food to become familiar to the child.

Cognitive Skills:   Use lots of language and descriptive words to describe the food – crunchy, chewy, cold, etc.  This provides information about the food before the child touches it or tastes it.  This increases familiarity with the food (and provides language stimulation, too!).

Key Phrases:   Provide clear instructions to the child – this avoids the battle of wills at the table.  Avoid the words “no,” “stop” and “don’t” at the table and provide acceptable, alternative behavior.  If the child throws food on the floor, you could say, “food stays on the table” or “you can push your plate away.”

If you are concerned about your child’s feeding skills, please talk with your child’s pediatrician, occupational therapist or speech-language pathologist as soon as possible.  Some children and families may benefit from a consultation with a pediatric nutritionist to assess the child’s caloric intake and needs.

For more information about the S.O.S. Approach to Feeding and other feeding and nutrition resources, please review the following links:

S.O.S. Approach to Feeding
Picky Eaters vs. Problem Feeders
Top 10 Myths of Mealtime in America
Feeding Strategies for Older Infants and Toddlers
P.O.P.S.I.C.L.E.

References:

Toomey, K. (2004).  The SOS (Sequential Oral Sensory) Approach to Feeding.  Presented in Nashville, Tennessee.